“I am responsible for the upkeep on my house and car, therefore, I take good care of both. My house and car have to last a long time. Would I take just as good of care of them if someone else was responsible for their upkeep? I’d like to think I would. Unfortunately, most people would not! The solution to our insurance crisis is to restore personal responsibility for a patient’s health to the patient.

When we rely on the government or insurance company to foot the bill for our healthcare, there is no incentive to be healthy. Healthy choices start at home, not with an insurer. Putting your health first is essential. Unfortunately, most people put it last until they have lost it.

My proposal for our healthcare system is to return to the era of major medical insurance and personal responsibility for our own health.”

I am old enough to have practiced in a time when patients paid for their medical care in the same manner that they paid for house or car repairs: with their hard earned money. Office overhead did not include a large billing department, insurance coders, and staff whose entire purpose was to deal with third party payers. Office visits were, therefore, much less expensive (even affordable).

Patients had “major medical” insurance. A “major medical” policy covered extraordinary expenses. Patients were responsible for their own health. If they wished to smoke or drink to access, they bore the burden of the medical cost incurred because of their unhealthy habits.

Over time, insurance companies realized that by enslaving doctors and patients, they could reap huge profits. They began by offering first dollar coverage to patients and began signing up large numbers of customers. They then marketed panels of patients to physicians who could only access those patients by signing contracts for payment. Over more time, the insurer started to tighten the noose around everyone’s necks.

Rates for insurance went through the ceiling while “reimbursements” for care plummeted. Insurance companies’ profits soared. Every time the insurer’s profits plateaued, they instituted new price hikes, new cuts in reimbursements, and new costly restrictions of care. Terms such as “prior authorizations,” “preferred medication lists”, “co-pays,” and “denials of care” came into being.

Today, we are in crisis mode. The cost of delivering care has risen to absurd levels. The economy is collapsing. While the insurers continue to post obscene profits, their clients and the medical profession teeter totter on the brink of failure. People are looking to the government to save and revamp the system. Our government has proven itself incapable of fixing anything. It is broke!

As in years past, politicians promise solutions. Obamacare promises to deliver better care for less money. If you believe that the addition of government bureaucracy to any system will provide better care for less money, then I have a bridge to sell you.

The only thing that will save our healthcare system is a return to personal responsibility for not just your health, but for your family’s health! No matter what happens to our healthcare system, if you are well, you will probably need very little healthcare. As healthcare needs decrease, healthcare expenditures will decrease and dependence on the system will decrease.

If you smoke, drink, or eat to excess, stop! If you don’t exercise, start! If you stress yourself and others, take a course in stress management or learn to meditate. If you eat out of cans and boxes, join a food co-op and have fresh, unprocessed food delivered to your house. Take better care of your body than you do of your house and car.

I can’t fix the system. Personally, I think things are going to get really bad! (Covert rationing of care and death panels already exists.) What I can do is help you find health. Preventative medical care, combined with taking personal responsibility for your health, will go a long way towards helping you avoid the catastrophe we call illness. Trust me, illness is your enemy and even simple illnesses will be more expensive and difficult to treat in the future.

2 thoughts on “Healthcare and Personal Responsibility”

The ACA adds more legislative reform than bureaucracy and makes individuals accountable by requiring that they have insurance to cover the cost of care when they need it. And certainly major medical is key. I have no doubt that those kinds of policies will come back into favor under the ACA.

You are absolutely right that it is the individual’s responsibility to maintain their health. That is paramount but it is not enough. My friend was young, didn’t smoke and was of normal weight. Her diet was exemplary. She was uninsured and took care of her body. She was by any account seemingly healthy when she was diagnosed with ovarian cancer. And then she was un-insurable and died within a year of diagnosis.

The ACA stipulates that insurance companies spend 80% of their revenue on the care of it’s subscribers, that changes some of what you hate about them. For me the requirement that all people be accepted regardless of pre-existing conditions is essential. The insurance industry has to be better regulated and will be with these changes in law.

Government in and of itself is not bad. It’s how we organize ourselves to create simpler things like roads and more complicated things like laws to uphold safety of all kinds. It is our personal responsibility to participate in and care for the health of our government too.

I support our President for taking this large and controversial step mostly because something needed to be done and it is what we do for each other that makes this country great.

Unfortunately, the results of requiring everyone to have insurance and of having the insurance industry accept all comers will be higher premiums for all and the rationing of care through ever increasing “prior authorizations” and treatment protocols. Freedom of choice will be sacrificed for the “good” of the masses! Sacrificing “freedom” for the sake of the masses has never resulted in anything but unspeakable horror.

Bio – Stewart Segal, MD

Dr Segal is a Board Certified Family Physician. He is the founder of Lake Zurich Family Treatment Center and a pioneer in open access medicine. He has been in practice for 32 years in Lake Zurich, Illinois. He is a physician educator, teaching both patients and physicians. He has served as a investigator in over 30 clinical trials. As evidenced by this blog and his office web site (www.lzftc.com), Dr Segal's passion is preventative medicine.

Disclosures

Dr Segal is the owner of Lake Zurich Family Treatment Center. Dr Segal has no ownership, stock or other financial interest in any pharmaceutical or device company.

Disclaimer

"The information provided on this blog is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with your physician or health care provider for your specific health care needs."